Optic Neuritis

*  Abrupt onset pain

*  Decreased vision

*  Positive Swinging Flashlight Test !!!  [see below]

*  Swollen optic disk on Fundoscopic exam
  • Loss of sharp margins, like papilledema
  • Pale disk (optic atrophy) if longstanding
*  Send to Ophtho for slit lamp Dx
  • Work up Multiple Sclerosis (50% of cases)

Swinging Flashlight Test

In a completely dark room, shine a light in the uninvolved eye
  • Pupil Constricts.
  • Shine it quickly over to the symptomatic side, Pupil Dilates!
  • Swing back to the uninvolved, Pupil Constricts.
  • Back to the symptomatic eye, Pupil Dilates!
  • Etc.

Chart:  “Afferent Pupillary Defect” (“APD”) for the side which dilates

See posting Red Eye – 1.

Advertisements